Healthcare Provider Details

I. General information

NPI: 1417927831
Provider Name (Legal Business Name): ROBERT MICHAEL KELLOGG PT PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

U.S. NAVAL HOSPITAL ROTA SPAIN PSC 819 BOX 18
ROTA CADIZ
FPO AE 09645
ES

IV. Provider business mailing address

U.S. NAVAL HOSPITAL ROTA SPAIN PSC 819 BOX 18
ROTA CADIZ
FPO AE 09645
ES

V. Phone/Fax

Practice location:
  • Phone: 34956823500
  • Fax: 34956823306
Mailing address:
  • Phone: 34956823500
  • Fax: 34956823306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12440
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number00025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: